Co-operation and Working Together Population Health Profile of the CAWT Region 1 cooperation and working together Foreword detailedfascinating core tablestables whichand graphs will act along as a useful with referencedetailed coresource tables in planning, which monitoringwill act as and a evaluatinguseful reference the work source of CAWT.in planning, The productionmonitoring ofand this evaluatinginformation thehas notwork been of straightforward.CAWT. 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Ireland.As As we inin CAWTCAWTwork work together forfor healthhealth gain gainB P Cunningham and socialsocial well-being, wellbeing, we we need need detailed, detailed, up-to- up Chief Executive todate date information information about about our residentsour residents in order in SouthernB P Cunningham Health and Social Services Board orderto effectively to effectively target targetresources, resources, both human both Chief Executive humanand financial. and financial. What is theirWhat state is their of health,state Southern Health and Social Services oftheir health, wider their needs wider and needslifestyles? and This lifestyles? CAWT Board ThisPopulation CAWT Health Population Profile Healthnow provides Profile timely now providesanswers to timely many answersof these questions.to many of these questions. This CAWT Population Health Profile Thiscontains CAWT a wealth Population of information, Health Profile many containsfascinating a tableswealth and of information,graphs along many with Population Health Profile of the CAWT Region 31 Foreword from the Directors of Public Health The four Departments of Public Health and population, this is the first time that such associated Information staff in each of the comprehensive data have been available on Boards in the CAWT region have worked the CAWT region as a whole. closely together, along with the Centre for Cross Border Studies, to produce this The report highlights areas of concern such as Population Health Profile. the rising number of births to teenage mothers and the rates of heart disease which Because of differences in data reporting in the exceed the rest of Ireland. two jurisdictions, a significant amount of re- working of data was required to produce the Our hope is that the Population Health Profile profile. For some key issues, no comparable of the CAWT region will help to focus the information was available between the four work of CAWT. It should provide a baseline Boards. against which progress can be measured in the While currently we each have data for our future. own Health (and Social Services) Board Dr. Rosaleen Corcoran Dr,Anne-Marie Telford Director of Public Health and Planning Director of Public Health North Eastern Health Board Southern Health and Social Services Board Dr. Sean Denyer Dr.W.W.M. McConnell Director of Public Health Director of Public Health North Western Health Board Western Health and Social Services Board 4 cooperation and working together Acknowledgements Contents The following groups and organisations have Executive Summary contributed to the production of this report. Working group – (Appendix 1) Information departments in each Health Board (Appendix 1) Introduction Public Relations Office (SHSSB) (Appendix 1) Northern Ireland Statistics and Research 1. Geography of the CAWT region Agency (NISRA) Central Statistics Office (CSO), Republic of Ireland Department of Health and Children - Public 2. Population statistics and trends Health Information System (PHIS), Republic of Ireland The Institute of Public Health in Ireland Northern Ireland Cancer Registry 3.Wider determinants of health National Cancer Registry Ireland CAWT office 4. Mortality 5. Morbidity and Health-related behaviours 6. Summary and recommendations 7. Sources of information 8.Abbreviations 9.Appendices Population Health Profile of the CAWT Region 5 Executive Summary Co-operation and Working Together (CAWT) now over 1000 births to teenage mothers in was established almost 10 years ago with the the CAWT region per year. Total Period aim of working together for health gain and Fertility Rates (average number of children social well-being in the area along both sides born per woman) mirror the pattern of live of the land border between Northern Ireland birth rates with the north/south variation. and the Republic of Ireland. This Population Despite falling family size in Northern Ireland, Health Profile aims to consider the CAWT population projections show an increase in entity as a discrete region and to identify total population for all four Health Boards issues which are common throughout this over the next 10 years. particular area of Ireland. The dependency ratio represents the number The CAWT region has a population of around of dependants for every 100 adults of working 1 million people – 21% of the total age, therefore a higher dependency ratio population of Ireland and 25% of its land area. indicates a greater burden on carers and It covers a wide geographical area with a low health services. The dependency ratio in the population density. Many people live in rural CAWT region is higher than that for either areas with resulting difficulties in provision Northern Ireland or the Republic of Ireland. and accessibility of services. The CAWT Population projections predict fewer numbers region as a whole is more deprived than the of children and an increasing percentage of rest of Ireland.This is true for unemployment, older people. This will further increase the economic dependency, age dependency, dependency ratio.The number of older people poorer housing and the particular problems of (65+ years) in the CAWT region is predicted low urbanisation. to rise by 17% by 2011.These figures suggest an increase in health and social care needs for The population of the CAWT region has the population of the CAWT region and this increased by 10% in the last 20 years.This is should be acknowledged in planning and slightly higher than the rate of rise in the resourcing services for this area. Republic of Ireland (8.8%) or Northern Ireland (9.6%).The live birth rates show north A wide range of life circumstances and /south variation. From 1990-1994, live birth lifestyle factors also affect health. Any rates for all four Health Boards in the CAWT community or organisation seeking to region showed a decrease. This trend was improve health must tackle all these wider then reversed in the Republic of Ireland with determinants of health for maximum health an increase in the live birth rates between and social gain, in particular the effect of social 1995 and 1999. Birth rates in Northern inequalities on health. This will require Ireland, however, continued to fall throughout partnership working with a range of other the decade. The number of births to teenage statutory, voluntary and community mothers in the CAWT region showed a 30% organisations to address the determinants of increase between 1995 and 1999. There are health and to promote healthy choices. 6 cooperation and working together Chapter 4 compares mortality in the CAWT Chapter 5 considers a range of illnesses and region with the rest of Ireland and examines health-related behaviours. This is not an some differences within the CAWT region. exhaustive list and many more could be The four leading causes of death in the included. However, the underlying difficulty CAWT region are 1) Circulatory diseases, 2) when studying morbidity and lifestyles is the Malignant neoplasms, 3) Respiratory diseases lack of robust, comparable data within each and jurisdiction and across jurisdictions. This is 4) Injuries and poisonings. Circulatory and one major challenge for those involved in respiratory diseases are each 4% more CAWT, if progress is to be measured in